雌激素对大鼠牙槽骨骨代谢的影响

目的 探讨雌激素防治大鼠牙槽骨骨质疏松的机制,为开发药物提供依据.方法 24只SD大鼠随机分为3组:对照组、去卵巢组和雌激素治疗组,每组8只.除对照组外,其余行双侧卵巢切除术.雌激素组给予炔雌醇100μg/(kg·d)灌胃,对照组和去卵巢组给予生理盐水对照灌胃,实验90 d后取大鼠牙槽骨,检测牙槽骨骨量、牙槽骨组织中抗酒石酸酸性磷酸酶(TRAP)和胰岛素样生长因子-I(IGF-I)活性.结果 与对照组相比,去卵巢组牙槽骨骨量明显减少;牙槽骨组织中TRAP阳性的破骨细胞数增加57.14%(p＜0.05);IGF-I表达变少、变弱(P＜0.05).与去卵巢组相比,雌激素组牙槽骨骨量明显增多;牙槽骨组织中TRAP阳性的破骨细胞数减少31.82%(P＞0.05);牙槽骨IGF-I表达变多、变强(P＜0.05).结论 雌激素能促进牙槽骨骨形成和抑制骨吸收,防治牙槽骨骨质疏松.     

雌激素对去势大鼠牙槽骨改建过程中IL-6表达的影响

目的 研究去势大鼠颌骨骨质疏松的病变特征及雌激素应用对绝经后骨质疏松牙槽骨中自细胞介素(IL)-6的分布及表达的影响,探讨雌激素对绝经后骨质疏松拔牙创牙槽骨改建影响的机制.方法 65只3月龄雌性SD大鼠随机分为2组:骨质疏松模型组(n=40)及假手术组(n=25).骨质疏松模型由切除卵巢法建立.2组中随机选取5只大鼠于术后8周处死.模型建立后,拔除所有实验大鼠的左上颌磨牙.骨质疏松模型组大鼠再进一步随机分为雌激素治疗组(皮下注射苯甲酸雌二醇)及未用雌激素治疗组,每组各15只,并随机选取假手术组大鼠15只作为对照.观察并分析上述3组大鼠颌骨骨质疏松的变化及IL-6的表达情况.骨质疏松情况用病理彩色图像仪分析组织形态学参数,IL-6表达采用免疫组化法.结果 卵巢切除后,模型组大鼠的骨小梁薄而少,骨小梁间距变宽,颌骨骨强度下降;应用雌激素治疗后,雌激素治疗组IL-6的阳性表达较未用雌激素治疗组减少.结论 3月龄SD雌性大鼠去卵巢8周后可发生骨质疏松;雌激素治疗对骨质疏松大鼠拔牙创骨愈合、牙槽骨中IL-6的表达有明显的抑制作用,从而有利于骨质疏松牙槽骨的改建.     

司吡合剂对去卵巢大鼠松质骨和皮质骨的影响

目的 建立去卵巢大鼠骨质疏松模型,通过骨形态计量学观察司吡合剂对松质骨和皮质骨的影响。方法 选取5月龄雌性SD大鼠30只,分为假手术组、去卵巢组、司吡合剂组。给药12周后处死大鼠,取第五腰椎、胫骨中段骨,进行骨组织形态计量学参数检测。结果 与假手术组比较,去卵巢大鼠第五腰椎松质骨的骨小梁面积百分数、骨小梁厚度减少（P<0.01）,而骨小梁分离度增加（P<0.01）,动态参数无明显变化;胫骨中段的皮质骨面积百分数减少（P<0.05）,骨髓腔面积百分数增加(P<0.05）,骨内外膜的形成和矿化均无明显变化。与去卵巢组相比,司吡合剂组第五腰椎松质骨的骨小梁面积百分数、骨小梁厚度增加（P<0.05）,吸收、动态参数无明显变化;胫骨中段静态、动态参数无明显变化。 结论 5月龄SD雌性大鼠去除卵巢12周后,可产生高转换型骨质疏松。司吡合剂能预防去卵巢大鼠造成的第五腰椎松质骨的骨丢失,但对胫骨中段皮质骨影响不大。     

骨灵片对去势大鼠骨小梁三维结构/骨强度的干预研究

目的 通过观察补肾中药骨灵片对骨质疏松大鼠腰椎松质骨二维平面和三维结构的改变以及对骨强度的影响,进一步探讨骨灵片抗骨质疏松的作用机制.方法 选取3月龄SD雌性大鼠18只,随机分为假手术组,去卵巢组,骨灵片低、中、高3个剂量组(根据人鼠剂量换算标准),以雌激素为对照组.通过硬组织切片观测二维形态计量学.在其基础上利用连续切片摄像及图像数码处理技术重建腰椎骨小梁的空间结构.结合计算机3D-Doctor软件测量相关三维参数.结果 去势后的模型组较之假手术组,骨小梁分离度明显升高,其余参数均显著下降(P<0.01);经骨灵片干预后的各组与去卵巢组比较可见,骨灵片各剂量组的骨小梁厚度显著增加,低剂量组对于骨小梁的面积百分数无明显增高,中、高剂量组在骨小梁数量、面积百分数、分离度上的改善较低剂量组显著.三维重建后的结果显示,高剂量组的骨小梁体积百分数和各剂量组的体元总数明显升高(P<0.01);骨灵片组与雌激素对照组相比,中剂量组在骨小梁厚度、体积百分数上的增加有显著差异(P<0.05),高剂量组的体元总数显著升高(P<0.01);相关分析显示三维体元总数及骨小梁体积百分比与二维骨小梁面积百分数、骨小梁厚度、骨小梁数量呈显著正相关,与骨小梁分离度呈明显负相关.各组骨小梁体积百分数在三维重建前后无显著差异(P0.05).结论 构建的三维模型结合相关参数测量的结果反映出模型组在骨小梁结构上存在典型的骨质疏松改变;经骨灵片干预后的大鼠,骨小梁的结构较之模型组有明显改善,尤其是中、高剂量组在骨结构的厚度、紧密性以及体积百分数上有显著升高.结合骨灵片对骨密度以及骨力学的改善,提示该药可以通过增强骨小梁实际结构的方式,起到增加骨强度,改善骨负荷,有效抗骨质疏松的作用.     

去卵巢大鼠骨质疏松经治疗后骨组织计量学的研究

目的 :建立大鼠骨质疏松模型 ;探讨去卵巢后雌性大鼠骨丢失的组织学机制及尼尔雌醇和左炔诺孕酮的治疗作用。方法 :通过图像分析仪对骨组织进行形态计量学分析。结果 :与假手术组比较 ,去卵巢大鼠组相对骨小梁体积、骨小梁平均厚度及骨小梁周长均显著减少 (P <0 .0 1) ,而成骨细胞指数、破骨细胞指数、骨小梁吸收表面和成骨细胞覆盖骨小梁表面百分比均明显增加 (P <0 .0 1)。尼尔雌醇和左炔诺孕酮治疗组上述各指标接近于假手术组 (P >0 .0 5 )。结论 :本实验去卵巢大鼠骨质疏松模型成立 ;去势后雌性大鼠骨丢失乃骨转换加快 (高转换型 )和重建负平衡 (骨吸收超过骨形成 )所致 ;用尼尔雌醇和左炔诺孕酮治疗能降低这种骨转换的负平衡 ,达到治疗骨质疏松的目的。     

Comparative study of the effect of exercise and estrogen on the bone mass and bone remodeling in ovariectomized rats

目的 对比分析运动及雌激素对去卵巢大鼠骨量和骨重建的影响,以探讨运动及激素在防治骨质疏松中的作用机制的异同及优缺点.方法 将48只5月龄雌佳Sparague Dawley(SD)大鼠随机分为基础对照(Basal)组、假手术(Sham)组、去卵巢(Ovx)组、去卵巢十雌激素(Ovx+e)组、去卵巢十运动(Ovx+ run)组及去卵巢十雌激素十运动(Ovx+ run+e)组.Ovx+e和Ovx十run+e组于去卵巢术后1周开始予己烯雌酚(0.025mg/kg)每日1次皮下注射,持续12周.Ovx+ run和Ovx+run+e组于去卵巢术后1周开始置于大鼠专用跑笼进行运动训练,跑速6.4 m/min,每日1次,持续12周.术后13周,对所有大鼠进行股骨骨密度(BMD)及骨组织计量学指标测定.结果 Ovx+e组的BMD显著高于Ovx组(P＜0.05),Ovx+ run组的BMD显著高于Ovx和Ovx+e组(P值均＜0.05),Ovx+ run+e组的BMD显著高于其他各组(P值均＜0.01).Ovx+e组的骨小梁面积百分率(％Tb.Ar)和骨小梁数量(Tb.N)显著高于Ovx组(P值均＜0.05),而骨小梁分离度(Tb.Sp)显著低于Ovx组(P＜0.01).Ovx+ run组的％Tb.Ar和Tb.N均显著高于Ovx组(P值均＜0.05),但显著低于其余各组(P值均＜0.05);Tb.Sp显著低于Ovx组(P＜0.01),但显著高于其余各组(P值均＜0.01).Ovx+ run+e组的％Tb.Ar和骨小梁厚度(Tb.Th)均显著高于各去卵巢组(P值均＜0.05),Tb.N均显著高于Ovx、Ovx+ run组(P值均＜0.05),而Tb.Sp均显著低于Ovx、Ovx+ run组(P值均＜0.01).Ovx+e组的周长百分率(％L.Pm)、骨小梁表面骨形成率(BFR/BS)、骨小梁总面积骨形成率(BFR/BV)、骨组织总面积骨形成率(BFR/TV)、骨小梁面积破骨细胞数(Oc.No)、骨小梁周长破骨细胞数(Oc.No/Pm)及骨矿化沉积率(MAR)均显著低于Ovx组(P值均＜0.05).Ovx+ run组的％L.Pm、BFR/BV均显著低于Ovx组(P值均＜0.01),而％L.Pm、BFR/BS、BFR/BV、BFR/TV、MAR、Oc.No和Oc.No/Pm均显著高于Ovx+e组(P值均＜0.01).Ovx+ run+e组的％L.Pm、BFR/BS、BFR/BV、BFR/TV均显著高于Ovx+e组(P值均＜0.01),而MAR、Oc.No、Oc.No/Pm均显著低于Ovx和Ovx+ run组(P值均＜0.001).骨组织形态图见Ovx+ run和Ovx+run+e组骨小梁排列较Ovx+e组整齐.结论 雌激素及运动均能使去卵巢大鼠骨量增加并抑制骨重建的高转换状态,雌激素抑制骨吸收和提高骨量的作用较运动更强,而运动更促进骨矿化沉积及骨形成,两者配合有协同作用.     

二仙汤对去卵巢大鼠骨质疏松的作用

目的:研究二仙汤对去卵巢大鼠骨质疏松症的作用.方法:去卵巢诱导大鼠骨质疏松症,12周后,取胫骨近端行不脱钙制片进行骨组织形态计量学分析;双能X射线骨密度仪测量股骨骨密度.结果:二仙汤能显著增加骨小梁面积百分比和骨小梁厚度(P＜0.01),减少骨小梁分离度(P＜0.05);增加骨形成参数:矿化沉积率(MAR)、骨形成率(BFR/BS、BFR/BV、BFR/TV)(P＜0.05, P＜0.01);减少破骨细胞数(P＜0.01)且显著增加去卵巢大鼠股骨骨密度(P＜0.05).结论:二仙汤对去卵巢大鼠骨质疏松有保护作用,主要是通过促进骨形成、抑制骨吸收、提高骨密度.     

去卵巢大鼠骨质疏松经治疗后骨组织计量学的研究

目的：建立大鼠骨质疏松模型;探讨去卵巢后雌性大鼠骨丢失的组织学机制及尼尔雌醇和左炔诺孕酮的治疗作用,方法：通过图像分析仪对骨组织进行形态计量学分析。结果：与假手术组比较,去卵巢大鼠组相对骨小梁体积,骨小梁平均厚度及骨小梁周长均显著减少（P＜0．01）,而成骨细胞指数,破骨细胞指数,骨小梁吸收表面和成骨细胞覆盖骨小梁表面百分比均明显增加（P＜0．01）,尼尔雌醇和左炔诺孕治疗组上述各指标接近于假手术组（P＞0．05）,结论：本实验去卵巢大鼠骨质疏松模型成立,去势后雌性大鼠骨丢乃骨转换加快（高转换型）和重建负平衡（骨吸收超过骨形成）所致。用尼尔雌醇和左炔诺孕酮治疗能降低这种转换的负平衡,达到治疗骨质疏松的目的。     

雌激素缺乏对牙周炎大鼠牙槽骨骨保护素表达的影响

目的 研究雌激素缺乏对牙周炎大鼠牙槽骨中骨保护素(OPG)表达的影响,探讨雌激素调节牙槽骨改建的机制.方法 采用切除双侧卵巢及牙周结扎的方法建立雌激素缺乏的大鼠牙周炎动物模型,观察大鼠牙周组织病理改变,应用免疫组织化学技术观察OPG在牙槽骨的表达,比较卵巢切除(OVX,n=18)、假手术(Sham,n=17)及雌二醇治疗(OVX+E2,n=18)3组大鼠牙槽骨OPG表达吸光度(A)值的差异.结果 各组大鼠组织学观察均显示牙槽骨骨小梁稀疏,牙槽骨表面可见破骨细胞及骨吸收陷窝,OVX组更为显著.Sham组、OVX组及OVX+E2组的牙槽骨OPG阳性表达A值分别为38 799±6228、27 854±5246和37 146±6394,OVX组吸光度低于Sham组和OVX+E2组(均P＜0.05),而Sham组和OVX+E2组之间差异无统计学意义(P＞0.05).结论 雌激素缺乏降低牙槽骨中骨保护素的表达,促进实验性牙周炎大鼠牙槽骨的吸收.     

不同剂量羟乙膦酸钠对去势大鼠颌骨的影响

目的 研究不同剂量羟乙膦酸钠对去势大鼠颌骨的影响.方法 4月龄SD雌性大鼠50只,随机分成5组.假手术组(Ⅰ),去卵巢组(Ⅱ),低剂量组(Ⅲ):去卵巢后给予低剂量羟乙膦酸钠[2mg/(kg·d)],中剂量组(Ⅳ):去卵巢后给予中剂量羟乙膦酸钠[4rag/(kg·d)],高剂量组(Ⅴ):去卵巢后给予高剂量羟乙膦酸钠[8mg/(kg·d)].动物去势后6周,羟乙膦酸钠粉未溶于蒸馏水腹腔注射连续1周,停药3周,如此重复3个周期,计12周.在HPIAS10000型图像系统进行骨组织形态测量,做生化指标统计.结果 骨形态计量显示药物干预组颌骨骨小梁面积,骨小梁宽度均较去势组明显增加,骨小梁间距明显减少(P＜0.05).去势组雌激素水平与假手术组比下降明显(P＜0.05),药物治疗组骨钙素较去势组下降,但组问差异无显著性(P＞0.05).结论 羟乙膦酸钠可有效预防去势引起的颌骨骨量的丢失.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.